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Richard D. Fischer, D.D.S.,
F.A.G.D., F.I.A.O.M.T.

4222 Evergreen Lane
Annandale, VA 22003
Telephone: (703) 256-4441
Fax: (703) 354-1631



July, 2012

See our new brochure on Sleep Apnea: download it here.

Dear Friends,

Over the past 30 years I have studied and utilized various health care modalities in my practice that serve to support and enhance the overall health of patients, family and friends. These studies have led me into such fields as clinical nutrition, homeopathy, oral orthopedics (TMJ), oral medicine and toxicology, acupuncture, and cranial osteopathy.

In recent years I have become increasingly drawn into the arena of medicine/dentistry dealing with Sleep Disordered Breathing (SDB) - commonly referred to as Snoring and Obstructive Sleep Apnea (OSA). Like many other people, I used to believe that snoring was ‘merely’ a social nuisance - particularly for the spouse and family of the snorer. Research, however, confirms that there are serious health implications for the snorer as well.

To understand why, let's look at what snoring actually is. When we sleep the muscles and other soft tissues of the throat relax and cause a narrowing or collapse of the airway. As a result of this collapse, the air flowing past the relaxed tissues in the throat cause them to vibrate as you breathe - much as a flag flaps in the wind - resulting in the harsh snoring sounds with which we are all familiar.

First - The Bad News

Snoring is always indicative of the development or existence of a sleep breathing disorder. During normal breathing our bodies produce a substance called nitric oxide (NO), not to be confused with nitrous oxide or "laughing gas." NO behaves like an antioxidant because it protects the inner linings of our blood vessels from damage or plaques - i.e. the beginning of cardiovascular disease. Recent research has shown that within seconds upon the start of snoring, the production of NO stops, leaving our cardiovascular system vulnerable to breakdown. Snoring can also activate the sympathetic nervous system (or "fight or flight mechanism") which in turn can lead to hypertension (high blood pressure).

Snoring may also be a major indicator of a more significant medical condition called "Obstructive Sleep Apnea" (OSA). OSA is, as defined by the National Heart, Lung & Blood Institute, "a breathing disorder characterized by brief interruptions during sleep ... repeated periods of no breathing for at least 10 seconds at a time." These periods are called apnic events and can last over a minute! It is not surprising then that people with OSA sometimes awaken grasping for breath. Untreated, sleep apnea sufferers have up to a 500% increased risk of dying during their sleep from a heart attack or stroke. They statistically average a reduced life expectancy of 8 years.

Risk factors for OSA include:
  • Anatomy of the airway
  • Weight gain
  • Increasing age
  • Bruxism (tooth grinding)
  • Misaligned teeth and jaw
  • Menopause
  • Family history
People with untreated OSA experience reduced blood oxygen levels and frequent brief arousals from their sleep. As a result they commonly experience daytime sleepiness, headaches, memory loss and up to 10 times the frequency of automobile accidents.

Currently there are 4 treatments approaches for snoring and OSA:

  • Weight loss
  • Surgical removal of soft tissue from the throat
  • CPAP - a forced-air pump to inflate the lungs
  • Dental mouthpieces (oral appliances)
At last count there are 88 different FDA approved oral appliances used to treat snoring. Until now their effectiveness was unpredictable for any individual person. While some were often effective in reducing the snoring, they sometimes worsened the OSA by further collapsing the airway.

NOW - The Good News

How can we help?

The science of Sleep Disorder Dentistry (SDD) focuses on reducing the breathing problems at night by determining the location and degree of the airway obstruction, and placing the airway in optimal breathing position to restore its potency.

First we “map” your nasal and oral airways with a quick and painless technique called “Acoustic Reflection Technology” (ART). Two tools, a Rhinometer and a Pharyngometer, use ART to take “pictures” of your airway with sound, allowing us to discover any points of obstruction as well as your optimal breathing position. In addition, the Pharyngometer is critical in determining whether oral appliance therapy will be successful - and to what degree!

The oral appliance looks like an athletic mouth guard, but it's much less bulky, and gently supports your jaw in the right position to maintain proper airway function as you sleep.

Sleep Disordered Breathing has been linked to:
  • Cardiovascular disease
  • Hypertension
  • Ischemic stroke
  • Depression
  • Attention deficit/Hyperactivity disorder
  • Memory loss (AD/HD)
  • Increased mortality
Because Sleep Disordered Breathing is of such great medical concern, the testing and treatment which we do is typically reimbursable to patients from their medical (not dental) insurance carriers. We will work closely with your medical physician to expedite this process.

If you suspect you or any loved ones may suffer from snoring or OSA, give our office a call for more information.

Sincerely,
Richard D. Fischer, D.D.S.









Copyright © 2012 Richard D. Fischer. All rights reserved.





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